Electroencephalographic sleep macrostructure and sleep spindles in early infancy

Study ObjectivesSleep features in infancy are potential biomarkers for brain maturation but poorly characterized. We describe normative values for sleep macrostructure and sleep spindles at 4–5 months of age.MethodsHealthy term infants were recruited at birth and had daytime sleep electroencephalograms (EEGs) at 4–5 months. Sleep staging was performed and five features were analyzed. Sleep spindles were annotated and seven quantitative features were extracted. Features were analyzed across sex, recording time (am/pm), infant age, and from first to second sleep cycles.ResultsWe analyzed sleep recordings from 91 infants, 41% females. Median (interquartile range [IQR]) macrostructure results: sleep duration 49.0 (37.8–72.0) min (n = 77); first sleep cycle duration 42.8 (37.0–51.4) min; rapid eye movement (REM) percentage 17.4 (9.5–27.7)% (n = 68); latency to REM 36.0 (30.5–41.1) min (n = 66). First cycle median (IQR) values for spindle features: number 241.0 (193.0–286.5), density 6.6 (5.7–8.0) spindles/min (n = 77); mean frequency 13.0 (12.8–13.3) Hz, mean duration 2.9 (2.6–3.6) s, spectral power 7.8 (4.7–11.4) µV², brain symmetry index 0.20 (0.16–0.29), synchrony 59.5 (53.2–63.8)% (n = 91). In males, spindle spectral power (µV²) was 24.5% lower (p = .032) and brain symmetry index 24.2% higher than females (p = .011) when controlling for gestational and postnatal age and timing of the nap. We found no other significant associations between studied sleep features and sex, recording time (am/pm), or age. Spectral power decreased (p < .001) on the second cycle.ConclusionThis normative data may be useful for comparison with future studies of sleep dysfunction and atypical neurodevelopment in infancy. Clinical Trial Registration: BABY SMART (Study of Massage Therapy, Sleep And neurodevelopMenT) (BabySMART)URL: https://clinicaltrials.gov/ct2/show/results/NCT03381027?view=results.ClinicalTrials.gov Identifier: NCT03381027     

Belief in the existence of multiple personality disorder among psychologists and psychiatrists

The present study surveyed the attitudes of psychiatrists and psychologists with regard to the existence of dissociative and multiple personality disorders. Questionnaires were sent to psychiatrists and psychologists in all VA Medical Centers. A total of 1,120 VA psychologists and psychiatrists completed the surveys. More than 97% of respondents indicated that they believed in dissociative disorders, while 80% reported a belief in multiple personality disorder. Belief in multiple personality disorder was related significantly to profession, age, and years of experience.     

Radiation in orthopaedics (RIO) study: a national survey of UK orthopaedic surgeons

Objectives:Orthopaedic surgeons have a responsibility to minimise risks of ionising radiation to patients, themselves and staff. This study aims to establish the understanding of radiation practice, legislation and risk by orthopaedic surgeons.Methods:A nationwide online survey of UK-based orthopaedic surgeons was conducted. Participants answered 18 multiple-choice questions assessing level of radiation safety training, basic principles/knowledge of ionising radiation, relevant legislation and operating practice.Results:A total of 406 surgeons completed the survey. 92% reported using intraoperative ionising radiation at least once per week. 38% received no formal training on radiation safety. Knowledge of basic principles of radiation and legislation was limited. There was variable knowledge when labelling an image intensifier machine and choosing its safest orientation. Poor uptake of radiation protection equipment was noted. Only 19% agreed they had adequate training in ionising radiation safety and 27% reported receiving adequate training in equipment emitting ionising radiation in the operating theatre.Conclusion:Many orthopaedic surgeons in the UK do not believe they are adequately trained in radiation safety. There is a deficiency amongst practicing surgeons in basic knowledge, relevant legislation and practicalities of the use of ionising radiation in the operating room. This could potentially put patients and health-care professionals at additional risk. We recommend that a standardised national training programme on the basic principles and safety of ionising radiation is implemented for all practicing orthopaedic surgeons.Advances in knowledge:This paper is the first UK national survey amongst orthopaedic surgeons and is one of the largest reported internationally.     

Immunohistochemical and qPCR Detection of SARS-CoV-2 in the Human Middle Ear Versus the Nasal Cavity: Case Series

Viral infections have already been implicated with otitis media and sudden sensorineural hearing loss. However, the pathophysiology of COVID-19 as it relates to otologic disorders is not well-defined. With the spread of SARS-CoV-2, it is important to evaluate its colonization of middle ear mucosa. Middle ear and nasal tissue samples for quantitative RT-PCR and histologic evaluations were obtained from post-mortem COVID-19 patients and non-diseased control patients. Here we present evidence that SARS-CoV-2 colonizes the middle ear epithelium and co-localizes with the primary viral receptor, angiotensin-converting enzyme 2 (ACE2). Both middle ear and nasal epithelial cells show relatively high expression of ACE2, required for SARS-CoV-2 entry. The epithelial cell adhesion molecule (EpCAM) was use as a biomarker of epithelia. Furthermore, we found that the viral load in the middle ear is lower than that present in the nasal cavity.     

Resin-supported iridium complex for low-temperature vanillin hydrogenation using formic acid in water

Biorefinery seeks to utilize biomass waste streams as a source of chemical precursors with which to feed the chemical industry. This goal seeks to replace petroleum as the main feedstock, however this task requires the development of efficient catalysts capable of transforming substances derived from biomass into useful chemical products. In this study, we demonstrate that a highly-active iridium complex can be solid-supported and used as a low-temperature catalyst for both the decomposition of formic acid (FA) to produce hydrogen, and as a hydrogenation catalyst to produce vanillyl alcohol (VA) and 2-methoxy-4-methylphenol (MMP) from vanillin (V); a lignin-derived feedstock. These hydrogenation products are promising precursors for epoxy resins and thus demonstrate an approach for their production without the need for petroleum. In contrast to other catalysts that require temperatures exceeding 100 °C, here we accomplish this at a temperature of <50 °C in water under autogenous pressure. This approach provides an avenue towards biorefinery with lower energy demands, which is central to the decentralization and broad implementation. We found that the high activity of the iridium complex transfers to the solid-support and is capable of accelerating the rate determining step; the decomposition of FA into hydrogen and carbon dioxide. The yield of both VA and MMP can be independently tuned depending on the temperature. The simplicity of this approach expands the utility of molecular metal complexes and provides new catalyst opportunities in biorefinery.

Solid-supported molecular catalysis for biorefinery. Hydrogenation using formic acid in water at low temperature.     

Correction: Expanded scope of Griesbaum co-ozonolysis for the preparation of structurally diverse sensors of ferrous iron

Correction for ‘Expanded scope of Griesbaum co-ozonolysis for the preparation of structurally diverse sensors of ferrous iron’ by Jun Chen et al., RSC Adv., 2021, 11, 34338–34342, DOI: 10.1039/d1ra05932g.

The authors regret that an incorrect version of Fig. S1 was included in the original article. The correct version of Fig. S1 is presented below.Fig. S1 Representative conformations of putative bridged bicyclic trioxolane adducts, modelled as the trans-N,N-dimethyl carbamates in the peroxide-exposed, iron(ii)-reactive chair conformation using MarvinSketch (v19.10).The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.     

Design,content, and fieldwork procedures of the COVID‐19 Psychological Research Consortium (C19PRC) Study – Wave 4

ObjectivesThis paper outlines fieldwork procedures for Wave 4 of the COVID‐19 Psychological Research Consortium (C19PRC) Study in the UK during November–December 2020.MethodsRespondents provided data on socio‐political attitudes, beliefs, and behaviours, and mental health disorders (anxiety, depression, and posttraumatic stress). In Phase 1, adults (N = 2878) were reinvited to participate. At Phase 2, new recruitment: (i) replenished the longitudinal strand to account for attrition; and (ii) oversampled from the devolved UK nations to facilitate robust between‐country analyses for core study outcomes. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was representative of the baseline sample characteristics.ResultsIn Phase 1, 1796 adults were successfully recontacted and provided full interviews at Wave 4 (62.4% retention rate). In Phase 2, 292 new respondents were recruited to replenish the panel, as well as 1779 adults from Wales, Scotland, and Northern Ireland, who were representative of the socio‐political composition of the adult populations in these nations. The raking procedure successfully re‐balanced the longitudinal panel to within 1% of population estimates for selected socio‐demographic characteristics.ConclusionThe C19PRC Study offers a unique opportunity to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic.     

Physician Perceptions of the FDA’s Breakthrough Therapy Designation: An Update

The US Food and Drug Administration developed the Breakthrough Therapy designation to expedite the development and review of drugs that show a clear advantage over available therapy for serious conditions. Prior research has shown that physicians tend to misunderstand that a drug may receive a Breakthrough Therapy designation based on preliminary clinical evidence (eg, effect on a surrogate endpoint or intermediate clinical endpoint that is likely to predict clinical benefit). The objective of this article is to examine whether physicians’ familiarity with and interpretation of the Breakthrough Therapy designation have changed since a survey on the topic was published in 2016. We replicated three of the questions in that study and explored beliefs that a Breakthrough Therapy designation automatically qualifies a drug for accelerated approval. We also draw comparisons by specialization (oncologists vs. primary care physicians). In general, physicians remain more likely than not to misunderstand the Breakthrough Therapy designation.     

Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy

BackgroundDelays in diagnosis of peripartum cardiomyopathy (PPCM) are common and are associated with worse outcomes; however, few studies have addressed methods for improving early detection.HypothesisWe hypothesized that easily accessible data (heart rate [HR] and electrocardiograms [ECGs]) could identify women with more severe PPCM and at increased risk of adverse outcomes.MethodsClinical data, including HR and ECG, from patients diagnosed with PPCM between January 1998 and July 2016 at our institution were collected and analyzed. Linear and logistic regression were used to analyze the relationship between HR at diagnosis and the left ventricular ejection fraction (LVEF) at diagnosis. Outcomes included overall mortality, recovery status, and major adverse cardiac events.ResultsAmong 82 patients meeting inclusion criteria, the overall mean LVEF at diagnosis was 26 ± 11.1%. Sinus tachycardia (HR > 100) was present in a total of 50 patients (60.9%) at the time of diagnosis. In linear regression, HR significantly predicted lower LVEF (F = 30.00, p < .0001). With age‐adjusted logistic regression, elevated HR at diagnosis was associated with a fivefold higher risk of overall mortality when initial HR was >110 beats per minute (adjusted odds ratio 5.35, confidence interval 1.23–23.28), p = .025).ConclusionIn this study, sinus tachycardia in women with PPCM was associated with lower LVEF at the time of diagnosis. Tachycardia in the peripartum period should raise concern for cardiomyopathy and may be an early indicator of adverse prognosis.